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Oct 1, 2014 Issue
JNC8 Guidelines for the Management of Hypertension in Adults [Practice Guidelines]
Hypertension is one of the most important preventable contributors to disease and death in the United States, leading to myocardial infarction, stroke, and renal failure when it is not detected early and treated appropriately. The Eighth Joint National Committee (JNC 8) recently released evidence-ba...
The Eighth Joint National Committee (JNC 8) recently issued the most anticipated hypertension guideline in some time. The most significant change in the JNC 8 guideline is relaxation of the systolic and diastolic blood pressure goals for adults 60 years and older. As a result of the new guidelines, ...
Aspirin does not elevate blood pressure. Among nonselective NSAIDs, ibuprofen increases the risk of hypertension and stroke. Diclofenac does not increase the risk of hypertension, but does increase the risk of stroke. Naproxen (Naprosyn) does not increase the risk of hypertension or stroke. Celecoxi...
See the Synopsis section for a summary of the updated hypertension treatment recommendations from the Eighth Joint National Committee (JNC 8).
It seems to be safe to lower systolic blood pressure to a target of 140 mm Hg in those with an acute hemorrhagic stroke. However, there seems to be no clinical benefit to this approach when the data are adjusted for baseline NIH Stroke Scale scores.
Vitamin D supplementation in patients with isolated systolic hypertension and low levels of vitamin D does not decrease systolic blood pressure after one year of treatment.
In this retrospective analysis, chlorthalidone and HCTZ produced the same clinical outcomes in older adults. In general, chlorthalidone was more likely to be associated with hospitalization for hypokalemia and hyponatremia. When comparing equivalent doses, though, the rates of these adverse effects were the same.
Pharmacologic treatment of mild hypertension for up to five years does not reduce coronary events, stroke, or mortality compared with placebo.
Consuming 50 g of cocoa daily will lower blood pressure 2 to 3 mm Hg on average in adults with hypertension. Evidence of improved patient-oriented outcomes does not exist.
The Journal Club authors discuss what factors make this meta-analysis, designed to determine whether the ARB-MI paradox is real or a statistical fluke, successful.